Tuesday, June 22, 2010

Every city in America, and likely the world, has a local magazine. And once a year, that magazine publishes a "Best Docs" issue, usually listing 10 doctors from each specialty who they consider the best of the best.

Dr. Grumpy, for the record, is not biased against this. I've been named a "Best Doc" in my field several times.

And I know most of the other neurologists on the list. Some of them are very good (likely better than me) but there are always a few doctors on the list who I know are incompetent, or even dangerous. Yet, they somehow made the list, too. And there are always quite a few damn good neurologists who never make the list at all.

So how does this happen?

It's hard to judge doctors. Even good doctors get sued, and have medical board complaints against them. I have a lot of patients who love me. And some who hate me and think I'm incompetent. You can't predict the vagaries of human chemistry.

Most of these magazines try to poll doctors. They send out ballots to local docs, and ask us to write down our favorites for each specialty. So to some extent it's really just a popularity contest. Other magazines have patients vote. Generally, an incompetent doctor with his name out there, doing TV and newspaper interviews, seems to be more likely to get votes then a competent person quietly toiling away in an obscure practice.

So what does it mean to be a "Best Doc" like yours truly? It's flattering, but here's what really happens:

I find out that I'm in the coveted issue about 1 month before it goes to press. This is because someone from the magazine calls me, to tell me that I made it, and (more to the point) ask me if I'd like to buy advertising space in the issue to complement my name being in it. No, thanks.

A few weeks later the magazine calls back, this time to see how many copies of the famous issue I'd like to buy, to give to friends, family, employees, patients, anyone. No, thanks. I subscribe to the mag, anyway, for my lobby, so I get one copy as it is. And that's enough.

Then the magazine hits the stands. A few things happen:

1. I get calls and letters from companies trying to sell me a plaque, framed copy of the issue, or something else to hang on my office wall to let people know I made "Best Docs". All at a special price of only $49.95 up to $199.95 (depending on what materials and how much bling I choose for my "limited edition" item). No, thanks.

2. I get calls and letters from investment companies, stock brokers, insurance salesmen, and financial planners, congratulating me on my recognition and wanting to meet with me to discuss my financial health, since obviously anyone who's on the "Best Docs" list must have a shitload of cash lying around. They even offer to take me to lunch. Sorry, guys, but whether or not we make "Best Docs" is immaterial to how much a doc really makes. And the reality of most docs today is that we're lucky to support our families. So no, thanks.

3. I get calls and letters from my city's professional sports teams, telling me that as a "Best Doc" my life isn't complete until I buy season tickets. This year a team offered me a free pair of nosebleed seats in exchange for me attending a 30 minute sales presentation on the benefits of season tickets. No, thanks.

4. A few patients see my name in the magazine and call for an appointment.

This is always the scariest bunch. I know it's not easy to find a good doc, but if you're coming to me just because Local Magazine said so, you'd do better asking your own doctor, or friends, for names.

In general, the patients who come to me solely on the magazine's referral are some of the most dreaded ones in my practice. Why? Because they've almost always been through several previous neurologists who weren't able to fix them. But, by a leap of reasoning, they assume that Dr. Grumpy, because he made the "Best Docs" issue, will be THE doctor who can reverse their 30 years of chronic pain. Who can cure Grandma's Alzheimer's disease. Who can work some incredible miracle that 7 previous, perfectly competent, neurologists were unable to. Nope. And then they get angry when they find out I'm no more of a miracle worker than the other docs were.

And what happens to the 1 copy of the magazine that I do subscribe to?

In past years I used to save them. Take them home, put them in a pile of stuff. I have no idea why. At some point I realized they were just a bunch of old magazines, and tossed them in the recycling can.

The 1 copy that comes here is glanced through by me, Dr. Pissy, and our staffs for a day or two, to see who else made the list. Then it joins the other magazines in the lobby.

And within 2 days of being put out there, it disappears. Taken by an unknown patient.

21 comments:

I live in the DC suburbs. Years ago, I was seeing an endocrinologist who was and is a damn good doc. I eagerly looked for him in The Washingtonian's best docs issue. He wasn't in there.

Appalled, I had a scan done of the cover and inserted my doc's picture via photoshop. I added the headline, "Washingtonian Makes Huge Error...etc." and mounted it on one of those wooden certificate plaques with the plexi cover and decorative tacks to hold it down.

It made him laugh out loud when I gave it to him. He has it on the wall in his office (it's behind the door, but it's there).

You right when you say that some of whether or not someone is consider a "Best Doc" or not is perspective. My favorite doctor was in a practice with 2 other docs before he left to do something else. I didn't like the other 2 because of their bedside manner, particularly Dr. X. My pastor, who goes to the same practice really likes Dr. X, whom I would go to lengths to avoid.

In NJ where I live, Best Docs , Best Lawyers are paid advertising special magazines, where the "best" pay handsomely to have their photos and CV displayed. The only thing realistic here is The Real Housewives of New Jersey.

Sorry to disappoint. For most of these, you are "chosen"by someone at the magazine, based on a variety of factors indicating your willingness to buy something from them. A plaque, bigger ad with picture, etc.PS Been there.

I strongly support Dr. G's idea of asking other docs. They will recommend some doc they trust. Also, nurses know a heck of a lot about what is going on, as well as people who have lived in an area for a while. I would like to think that all docs are capable and competent healers, but the truth is, there's crazies everywhere. In my town, the crazy neurologist has an arsenal in his car trunk, just because. Also, he's got some "deal" Teva because he only prescribes Copaxone for MS tx. All that said, congrats, Dr. G. on being the Best!

I'm on Medicaid so it's hard for me to even FIND a doctor. You mean people get to pick...their doctor??? Wow!

Well if I ever find a neurologist, urologist, and a GI doctor I'll let you know. LOL.

Oh yeah I'm on Copaxone too but I have to talk my primary care doctor into prescribing it because I don't have a neurologist anymore. She dropped me because I went on Medicaid. Pffft. Sorriee... I don't like them either! No TEVA help there.

Nobody ever votes for "Best ER Doc"for some reason (although I guess it is good they don't). I guess you would have to assess how many central lines I hit on the first shot, how many tubes I made, and how many people I sent home who died from an MI.

I kinda agree with hannah - but then again, I don't have a ginormous school fee/load/debt to pay off ;-)

When I was a floor nurse, I had a patient in for a post-cystoscopy (complications). Part of the orders said "Beer 1-2 cans with dinner Daily".

The next morning (I work nights), I tracked down the urologist and announced: "Uro Doc, can you be my PMD?" When he asked "why?" with much bewilderment, I said "any Doc who orders beer for his patients can't be bad!" LOL

Now to the subject on hand: Grumpy, you make "my list" simply because you sound like a competent Doc and a HUMAN BEING. Hell, one of your 'selling points' is that you have a sense of humor! I like that in a Doc - it usually means that the Doc has good bedside manner.

since the line has taken this turn- the money is good. ok. that is to pay for years, study, effort, talent, skill, the loans, sleepless nights, availability, a modicum of social skills, responsibility. and for most of us it allows us to take self-interest out of clinical decision making. do what is best for the patient. simple. and what do we pay our entertainment?

Very enlightening post! --- I always figured being named in one of those magazines was a mixed blessing. And it is interesting how the ads always match up with the docs and clinics that are prominent in the listings..

Late to the party again, sorry. (Obviously I'm reading through your archives. :) )

I'm a lawyer, and while I don't practice med mal, I quite distinctly remember from Torts that the number one indicator of whether somebody was likely to sue a doctor for malpractice was whether or not the patient liked them. The correlation was much higher than either the extent of the malpractice or the severity of the resulting harm.

I suspect this is gradually changing as we become a more litigious society, but I thought it was interesting. I likewise suspect this may have a lot to do with the "Best 10" selections who you believe to be professionally sub-optimal. Doesn't matter if the patients get the best results or even good results, so long as they like the doctor or the doctor manages to make them think they know what they're doing, they'll vote for that doctor.

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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